1. Field of the Invention
This invention most generally relates to single use suction catheters. More particularly the invention relates to a construction of a single use open suction catheter for use in the suctioning of the airway of tracheostomized patients in order to remove unwanted tracheobronchial secretions from such a patient with the tracheostomy tube in place. Most particularly, the suction catheter, is about one-half the length of known and commonly used single use suction catheters, having means for connecting the proximal end (the end nearest the source of vacuum) to a source of vacuum, means for controlling the extent of the vacuum or negative/low pressure at the distal end (the end nearest the patient) and further the suction catheter may incorporate one of a variety of tip designs or components at the distal end thereof to improve the patient safety and the effectiveness of the removal of the secretions. The outer surface of the flexible tube and the surface of the lumen running through the tube may be coated with anti-bacterial and/or lubricating materials.
2. Description of the Prior Art
The use of suction catheters to remove tracheobronchial fluid from both the intubated and non-intubated patient is well known in the art. These catheters are made of plastic or rubber and are connected to a vacuum line via a connector or a vacuum control valve. This valve regulates the vacuum by covering a vent port with the thumb of the clinician who is doing the suctioning of the patient. The length of the currently known and widely used catheter is typically 20-24 inches. The length has to be long enough to pass through a swivel access port, nasal length endotracheal tube, and reach the carina (bifurcation of the trachea into the right and left lungs). Thus the currently used catheters are long enough to be used both for the suctioning of the nasopharyngeal airway and the tracheobronchial tree.
No clinician would dispute that suctioning an airway is hazardous. The procedure can cause hypoxemia, cardiac arrhythmias, hypotension, hypertension, damage to the tracheal mucosa, infection, increased intracranial pressure, cardiac arrest, and even sudden cardiac death. A primary goal is to minimize these risks.
The following patents known to inventor hereof, do not in any manner suggest or teach the catheter disclosed and claimed by applicant in the instant application for patent. All of the open, single use suction catheters known to the inventor hereof are of a length sufficient for use with intubated patients being ventilated with an endotracheal tube via the nasal passage, the mouth and throat and also those patients fitted with a tracheostomy tube in which instance the catheter is of considerable excess length.
U.S. Pat. No. 3,848,604, to Sackner, issued Nov. 19, 1974 teaches a suction catheter having a laterally extending flange means and a plurality of apertures through the tube at the distal end to reduce the potential for indrawing of the mucosa into the catheter thereby causing damage to the mucous membrane and mucosa of the tracheobronchial tree.
U.S. Pat. No. 3,991,762, to Radford, issued Nov. 16, 1976 is for a closed suction device having a patient end that fits directly onto the endotracheal connector, a plastic sleeve and a normally closed self biasing suction valve.
U.S. Pat. No. 5,419,314 to Christopher teaches a transtracheal catheter with total length being approximately 20 cm, 20 cm being shorter than conventional transtracheal catheter lengths. It should be noted that Christopher uses the transtracheal catheter to provide ventilation. Particularly, the invention of Christopher is for weaning a patient from a ventilator by augmenting respiration with the flow of supplemental oxygen. At a negative pressure with this device a patient would quickly desaturate. There is no use proposed for suctioning.
U.S. Pat. No. 5,186,168 to Spofford et al, discloses a catheter for providing supplemental oxygen and Spofford et al. teaches that the length may be shorter to prevent certain problems. Again the catheters are not used as single use suction catheters but are used to supply supplemental oxygen to spontaneously breathing patients with chronic lung disorders. Negative pressure delivered with this device would induce hypoxia by removing the patient's oxygen.
U.S. Pat. No. 4,990,143 to Sheridan teaches plastic helix reinforced tubes and that tracheal tubes are made in a variety of sizes, such tubes ranging from about 10 to 40 cm in length.
U.S. Pat. No. 4,796,617 to Matthews et al, discloses a tracheostomy tube assembly and ventilation system and is used to allow the positive pressure oxygen delivery to exit the tip of the device before the carina in order to deliver oxygen to both the right and left lungs. He teaches a tube length that is close to the patient's carina but does not reach it. The tube maximum length is about 100 mm (approximately 4 inches) from the flange. It is suggested that the Matthews device could be used to introduce a suction catheter through for the removal of tracheobronchial secretions. His device could not be used for suctioning.
U.S. Pat. No. 4,691,702 to Chantzis discloses an aspirating device with a desirable catheter length of about 560 mm (22 inches), and further teaches that the length of the catheter will be influenced by compatibility with other respiratory devices being used with the catheter and by accepted medical standards for the procedures being performed. The Chantzis device is a multiple use catheter that is indicated to remain connected to the patient's breathing circuit for an extended time period.
Damage to the tracheal mucosa and to the carina may frequently occur when the single use open suction catheter of known and accepted length (20 inches-24 inches) is used on a tracheostomized patient. The excessive length of the catheter will permit a clinician to insert the catheter tube so far as to "bump" into the carina or pass further into most probably the right bronchial passage. In both instances damage to the mucosa very likely takes place. Such trauma can be very easily eliminated or substantially reduced by using a short open single use suction catheter--a tracheostomy length single use suction catheter according to the catheter disclosed and claimed herein.
There are no patents known to the inventor which cover tracheostomy length single use open suction catheter. It has been apparently unobvious to all in the suction devices market, that a tracheostomy length single use open suction catheter (flexible tube length of between about 5.5 inches and 14.0 inches and an overall length including thumb valve of between about 7.25 inches and 15.75 inches) has considerable advantage over the longer 20 inch-24 inch known single use suction catheter.
It would be advantageous to have a suctioning device and method which would reduce the risk of trauma as a result of using standard suctions catheters with tracheostomized patients. The invention has the particular objectives, features and advantages of: 1) Reduction of patient discomfort; 2) Reduction in tracheal/bronchial mucosa damage because of the shorter length; 3) A substantial increase in suction efficiency--about twenty five percent (25%); 4) Substantially better control of rotation of the distal/patient end (end within patient's airway) from the control valve end such rotation effective to "sweep" the secretions to affect better and more thorough suctioning; 5) Since the catheter is single use and the instant short catheter is about 50% the length of known and used there is a 50% reduction in the amount of waste including storage, shipping cartons, and lower sterilization costs; and 6) Reduction in hospital storage space needed to store disposable single use suction catheters.
The patents noted herein provide considerable information regarding the developments that have taken place in this field of technology. Clearly the instant invention provides many advantages over the prior art inventions noted above. Again it is noted that none of the prior art catheters meets the objects of the short suction catheter in a manner like that of the instant invention. None of them are as effective and as efficient as the instant catheter for use in the suctioning of tracheostomized patients.